Individual provider Active NPI

Liliane Antoniutti Brantes, D.D.S.

  • Dentist
  • Centennial, CO
National Provider Identifier
1629063276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105807 Issued in CO
Practice address
6979 S Holly Cir
Suite 225
Centennial, CO 80112-1577
Phone
(303) 779-1305
Fax
(303) 779-1869
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 105807 CO Primary

Addresses

Primary practice location

6979 S Holly Cir
Suite 225
Centennial, CO 80112-1577

Mailing address

6979 S Holly Cir
Suite 225
Centennial, CO 80112-1577
Phone (303) 779-1305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105807COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
SJ Dental PC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629063276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "SUITE 225",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577",
            "telephone_number": "303-779-1305",
            "fax_number": "303-779-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "SUITE 225",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577",
            "telephone_number": "303-779-1305",
            "fax_number": "303-779-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTES",
        "first_name": "LILIANE",
        "middle_name": "ANTONIUTTI",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "105807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.